tena koe – kotora thank you very much for attending today's briefing on Easter Sunday and really appreciate your ongoing support and interest so today we have 18 new cases of covert 19 to report this comprises fourteen new confirmed cases and four probable cases there are no additional deaths to report so the total number of deaths remains at four there are now 471 reported cases of covert 19 where the people have recovered from their infection this is an increase of 49 on yesterday as you will see then we continue to report more recovered cases than we do new cases the new total of combined and probable cases in New Zealanders 1330 today there are 14 people in hospital one each and Wellington middle more whydo in Blenheim Dunedin and Northshore hospitals one of these patients in ICU of the total of five and I see you are in a critical condition so the 14 people in hospital five in ICU one of whom is in a critical condition in Dunedin for the cases we have information on the strongest link is with those who are contacts of existing cases that's 47 percent while 40 percent are linked to overseas travel two percent IRR confirmed is community transmission while 11 percent are still under investigation that's a reduction from 18 percent a week ago in terms of testing yesterday it was a quieter day I think reflecting the Easter break in 2421 tests were processed the seven-day rolling average is now 3523 and the total number of tests undertaken is 60 1167 and we will of course include those updated figures on our website just want to comment on aged residential care is a key setting we Kevin currently three significant covert 19 clusters in aged residential care facilities two are in Christchurch and one in the Waikato now we know from international reports and of course our experience here with four three deaths over the last three days sadly with the deaths over the last three days this is a group that is particularly vulnerable to a poor outcome if they do get infected with this virus we are prioritizing a range of actions around us and the DHBs in the ministry have worked very closely with H residential care providers and their umbrella groups right since early on in this outbreak very early on in the piece I sent a message to each residential care facilities even before we had very many cases in New Zealand to prevent anyone coming in both staff and visitors who may have any symptoms of a respiratory illness and likewise very soon after that we advised them to restrict visitors in fact stopped any visitors other than those that were for compassionate reasons yesterday to supplement this I wrote to all District Health Board chief executives again asking them to systematically assess the readiness of all ages in intial care providers in their area and to provide support and assistance as necessary so the DHBs will look at each facility's plans and procedures to ensure that they are reducing any risk to residents and staff and this will include assessing PPE stocks how it is being used and also to ensure that there is a ready supply of PPE for those facilities we've produced very clear guidance and updated that yesterday on the measures that resident these facilities need to have in place to protect staff and residents and most important here is courses that any staff who are unwell even with any mild symptoms or who have maybe a close contact of an existing or probable case do not come to work and the the units must have in place very clear policies and procedures for how they treat any possible or suspected cases so there are a number of steps underway to continue to work very closely with our aged residential care sector to ensure that we are keeping both the residents and of course staff safe there in terms of the Rosewood residents who are currently at vu wood hospital there was a question asked yesterday about this and in particular why they are not treated as hospital admissions so the Rosewood residents were transferred to Burwood last week from what we would call a high level psycho geriatric or dementia care unit the care they are receiving is consistent with that high level of care they would have received if they had remained at Rosewood and includes where appropriate end-of-life and palliative care it's true that they are indeed now ANBU had been cared for by the HB nursing health care assistants and other staff but as would occur in the unit that they came from the medical care is overseen by the GP even while they are in Burwood so the care that has been provided is not medical care per se just because they happen to be in a hospital setting it is the care in support they were receiving that when they were at Rosewood just an update on clusters we considered continue to keep a very close eye on our 13 current clusters and we recognized the significant public interest in the management of them just a some clarity around one of the clusters yesterday that was named as being related to spectrum Kia and I know there have been has been concerned from people who receive services from spectrum care and I want to reassure you that there is no need for concern there the current cluster has 28 confirmed of all probable cases and as the director of public health Caroline Mecca I mentioned yesterday these originated in the community and subsequently led to an infection of a person linked to spectrum care however it's not a cluster that had its origin within the victim care facility a small number of the cases though are related to that to spectrum care and work there in this case five all the positive results in tributed to this cluster are cases other cases are in the community and include household and other close contacts and a can say that the spectrum care staff have followed all appropriate actions including self isolating staff while they recover and are working closely with the Public Health Unit up there Auckland Regional Public Health and a couple of comments to finish on and I've said this each day for the last week it's very important people seek timely care for their health care needs we have seen and you've seen stories of a drop-off in emergency department presentations and I've just had the latest report from health lines showing that many people who are calling have got quite serious symptoms when they do call people should not be either afraid of seeking care nor should they delay doing that emergency departments doctors surgeries After Hours facilities all have in place very clear processes to separate out people who might have respiratory symptoms and might be being investigated or subsequently investigated for suspected Cova 19 from others who are seeking other care for other conditions so people should not delay seeking care they should bring health line get advice they should bring their regular GP and likewise anybody who has respiratory symptoms and feels they need or should be getting a test should seek advice either through health line or through calling their own GP and they will be giving it a given advice about where to get swabbing done at their load local community based assessment centre finally a message around Easter as I said earlier and as you will all know it's Easter Sunday so think particularly about older friends and far know we know Easter can be a hard time for a lot of people who may not be around friends or family at a time when we are usually very close to our friends and family so if you can the CSIs than they do Sunday do reach out across the generations call or virtualize your messages to family and friends I know many people will doing that and I thank you and encourage you to do that this is a collective effort and we will get through this if we continue to support each other so cured I thank you again and I'm happy to take questions you've repeated that message to us a few times here but do you think you took you too long to keep saying that message of people ignoring that and and are you captured that message is getting across to people I think the message is getting across through a range of channels and we've seen the report other reports about IDI attendance has been down as soon as we got a hint that this was happening over a week ago we started to press it home very clearly every day and likewise DHBs GPS the College of GPs and others are emphasizing that message there is capacity on health line to attend to everybody's health needs the wait times are tiny now the median time to pick up a quarter under 10 seconds so we need people to keep using health line keep using and calling their GP who may be able to provide advice over the phone and that will be important well from the beginning we've also always said that accessing healthcare we're weather etc or at a hospital or some other healthcare as an essential service and it's one of the very few reasons right from the start of alert level 4 we have been encouraging people to seek that and that's a bonafide a reason for being out and about is seeking health care and again just emphasizing that so it's not so much a review I have just asked them to as part of their ongoing work with Adria's it intial care to get teams out there to actually engage with and visit each facility and include and they team both clinical and infection prevention and control expertise so they can basically support these facilities in their work identify any support and needs they may have end address those you will all be asking them for an update and I'll be happy to just you know reflect on that and in progress were fed work can you update us on the New Zealanders returning from the Greek more than a cruise ship today any of them unwell and what exactly will happen to them so what I can say is that 13 of the 16 New Zealanders will be arriving and brought into Auckland I understand that none of those people are unwell enough to require hospital level care so they will be going into an isolation facility because they're coming out of a situation where there was very high level of infection and we're considering at high risk they will all be treated as if they are high-risk and we will be testing them all and then they will be in a quarantine facility for the 14 days regardless of the outcome of the tests I don't have any further information and there that investigation is ongoing what we tend to find in because over the last few weeks there haven't been visitors coming into these facilities the most likely source of introduction is saw a staff member that we that hasn't been confirmed in either of those two clusters is here but as soon as we do have that information more provided the residents from Roseland how many so at the moment there is no plans to move more of them to be looked after in the Burwood setting the bird hospital setting what I can say though was and in dr.
Michael knife leg this yesterday that you know these are people who are older they are frail they have high care needs and there is a number of them with Cova 19 in fiction and we may well see further deaths over coming days I think I'm you know just to be honest with you about that we're not we're continuing not to not treat them as hospital admissions these are people who are receiving exactly the same care and support they would have if they had been at Rosewood it's just a facility that is better able to look after them at the moment particularly because a number of staff members at Rosewood were affected and they were having they would have had trouble staffing the unit to continue to look after these people something like testing staff members and you mean an eighth resident yes so there's been some publicity about the Adria dental care sector looking for routine testing of any new resident coming in about 700 new new people are admitted to aged residential care each week our viewers that testing is it would be one of a number of things you can do particularly if anyone's symptomatic so yes test anyone's symptomatic and all new residents are required to go into a 14-day isolation period however testing is is of appropriate testing is just one part of how to keep both residents in staff safe and clearly good and fiction prevention control access to an appropriate use of PPE and so on the mainstays really an excellent hygiene and cleaning and those facilities we've been working with the sector really closely and will continue to do so what I would say though is that in that setting if we do get cases as we have in a number of facilities we may then test asymptomatic people as we have in some other healthcare settings just to get a picture if we're not clear about what the direction of the infection is it's an it's an Asst – a judgement and assessment by the local medical officer of Health who is it who is very aware of what the situation is on the ground and whether it's clear what the source of infection is what the likely spreaders and how many close contacts there are there may well be testing happening appropriate testing there I don't have the details on it but again it's a judgement it's actually a judgement for the local medical officer of Health so we've had the example down in Queenstown at Lakes Hospital I've talked about where they found a staff member with infection and then they tested around 30 other staff who were symptomatic they found another one and then extended it to the full around 70 staff and found I have subsequently found I think one further people person affected so it's a judgement of the medical officer of health and they will know when it is appropriate to use wider testing you'll recall we also that this very early on with the case in a Dunedin school where we we're a civil I think several hundred or well over a hundred students were tested because we wanted to be confident we knew what the the origin of that infection was so the bluff wedding was an event at a place from people who had come from all around the country and some who had flown in from overseas and it affected not just those who attended the event but also they were also the potential of affected staff there this was a private my understanding is this was a private event and we'll we'll keep reviewing it and we've been very keen to be as open as possible but at the moment it's a private event and there's no particular all the people who are associated with it have been identified and put into self-isolation and anyone who becomes symptomatic as being is being tested so there's no sense that there would be the risk of wider transmission beyond the people who were at that event and close contacts yes I think that's that's certainly a perspective that you could put on this I think at this point in time it's a it's a well bounded private event and we're comfortable with insuring of course that we keep identifying that there is a cluster ended providing an update on any additional cases each day yes and actually that that is probably better described as a community cluster that includes some people who work at Spectrum care so it's not actually a workplace based cluster it just involves folk working at Spectrum care Wellington yes so what I can say about that is that just to be clear that the person who died on Friday became infected as part of the bluff wedding event that's right yes here Association sees there was criticism from public health of staff not working in the designated zones what concerns did you have remedy we said at a specific facility was I think it was just a gym leader across from the AG Association could you just repeat their quote from the letter so the education is here there was criticism from public health of staff not working in designated zones I just don't feel I can comment further on that peps without understanding the context context it was at elicit to me supermarket flex mere yes I understand other people corrective action being taken around the yes very active and that person it's very clear that the person didn't get the infection in their workplace and it's been very clearly carefully and closely managed by the local Public Health Unit my team have spoken with the medical officer of Health who has very good understanding of what the where the origin of the infection was who the close contacts are and all the appropriate action is in place here my understanding it that it was the the index case there had traveled to another place and it might have been Queenstown and that's where the infection was was from how many patients am i understanding it is it's the patients who were on in that ward at the time the nurses were working there and there's no evidence to suggest that any of those when I last heard that the any of the people on the ward the the patients on the ward are infected and so it seems that the staff had got the infection from outside of the workplace down store I don't on the staffer to stood down I do know that there are now three cases associated with that and I understand that they are all staff members we feel we're doing from hearing from key workers across mini D H B's they still have very little or no access to PPE despite the announcement on March 31 that they would be able to access it why is it still happening what I am confident in is that D H bees have PPE that they have good policies in place and they are ensuring that staff that need access to PPE in their work are getting it and that's the reports I'm getting from many staff from across the sector and you will also see media reports about that there is very good and access to appropriate PPE for when it is required why now well we've worked really closely with this sector right from the start from very early on I think my team in the ministry focused just on this and the D H bees have been very focused it's not so much of why now it's what I'm letting you know is we're doing this is an additional measure partly because we've got the the the outbreaks and several facilities but also as we think about getting out of loot level four we want to be really sure that these settings are watertight to be able to protect staff and residents and one of the ways to ensure to satisfy ourselves of that is to make sure that the right people have gone and and just tested because what we have found is with the clusters that have broken out that there were some deficiencies in the in the actual procedures and how those were being implemented and we want to make sure that every facilities got really good plans procedures access to PPE and knows how to use it I don't have specific examples yeah about so about again and this has always been a key point around PPE it's it's not straightforward to use and people have to be taught how to use it properly even just using a facemask a simple surgical facemask has to be done properly so that's part of the action now is to just make sure and we do know many many of these facilities have got excellent procedures and policies and the staff are trained we just want to reassure ourselves particularly as we contemplate our moving down early levels so it's not just efficiencies and helping protect it what is important is helping protect staff and residents from any infection in the first place it's then what happens once there is an infection to prevent further spread both to residents and staff and that requires really really good policies and procedures that need to be tried and tested and that's what I'm asking the DHB staff to get out there and make sure all facilities are on top of it know we updated the general advice to aged residential care just yesterday just to update that in light of again what we're learning as we go through this some through this situation the current quite understands yes something just a little bit different was in really really small versions of weddings going here but it's just the the the you know the capital and in the celebrant as well should we things like that still be going here during lockdown also any more for well I guess if the celebrant is from the bubble of those people then yes if not to then I think it's questionable although it could be be done being done virtually of course Susan so they're inverse in the same location different bubble should they still be allowed to issue you know you know licenses and you know hold these ceremonies well they may be doing that in a way that isn't creating any over any overlapping of their bubbles I don't have it's hard to comment without any detail and but but I think people have a really good understanding of what what is what they need to do to help protect themselves and those in their bubble and I assume like keeping their maintaining the integrity of the of the bubbles if not I'm happy to look at any specific examples well I do know the Ministry of Education and the sector is doing a huge amount of work to look at how education can be delivered right across the spectrum from early childhood education through to tertiary education once we step down out of level four and further and I can't comment on that work I know it's ongoing but that will be the primary consideration will be ensuring that both the students and of course the folk working there are safe we're looking at this specific initiative which from my understanding is about using this method of having devices connect via bluetooth to be able to recall information around proximity now this is the approach that Singapore has been using and we've I think you heard the P and the other day talk about that she'd conversed directly with the prime minister of Singapore about the approach they're using the error specific app so yes we're following and we've actually talked with or my team have talked with the the local Google and Apple folk about the work they're doing that won't be available till mid May and we're hoping to get some sort of up sooner than that that would be able to provide information that there would support our contact tracing indication of what schools were waiting on public health advice what is that advice that well we're providing advice right across government about if we were to move to elute level 3 or when we move to elute level 3 what are the sorts of things you would need to have in place to help ensure that we were minimizing the risk of of community spread and community outbreaks so that's around physical distancing hygiene cleaning and so on so each sector then takes that advice and translates that into what that might mean for either their business for their school for other settings including for example in the hospitality sector what's possible within those parameters so look there's a lot of active work happening and that work that advice is going not just to education but to all government it's a specific advice we've provided some initial advice and will continue to provide advice so that that work is happening at pace because all of us will go into informing the government's decision of course about when to step down from a looot level for so the advice is ongoing we're working closely with the education and all of our other government colleagues can I I'm just having a look at the all of government information I look I don't have information on the compliance I can say that that the total number of breaches now is wait 847 and 109 prosecutions have been have flowed from that 717 warnings in 21 youth referrals but I don't have a further breakdown on particularly I know the police has been have been very active over the Easter weekend stopping cars and also the high presence and the community yes so they'll be treated as if they are is if they are covert 19 cases so they'll go into our sort of highest level quarantine facility which is for the people who come off flights into our symptomatic so that all be tested and they'll all remain an inmate quarantine for the full 14 days yeah the logistics similar to what we did for the folk who came in from Wuhan so it's all a very carefully managed stage managed process to reduce the risk to others we right from when they land and then that taken through into the enemy and of course the testing and assessment is done when they arrive and and then of course they looked after very well once are you oh yes I can and of course this is what we've been doing for some weeks now we tested it and did it when that very first flight came out of Wuhan and this is what's being done now with any flight that's coming in from overseas with people and anyone who has got symptoms recalling that the number of people coming in just on regular flights now it's quite low I just had the number here so 257 arrived yesterday we've got the 13 coming in on this flight and there'll be it's a it's a special era medical evacuation flight so there'll be a special team that'll work with those people to get them through the customs and biosecurity and then off to where and in assessment and then off to where they'll be looked after for the 14 days just back on it and later from before I've just been seen and just a little bit more information on there so I understand it's a liter from aged care association out to providers it says here there have been criticisms from public health and fiction control specialists about staff not working solely with only a designated areas and are you aware of that criticism well not specifically but as I said earlier on what we have found when we have gone into investing or public health staff have gone in to investigate the clusters there have been some deficiencies in the policies and procedures and that may well be what is reflecting and been reflected in the letter I suspect they the the Association has been encouraging its members to make sure that their policies and procedures are watertight and that they will also have the support of district health boards who will be going around and working with them to do that perhaps one more question it is encouraging clearly and what we'll be wanting to see over coming days is a an increase in the testing numbers again after the sort of quiet period over Easter we want to be doing more testing to find out if there are any cases out there and particularly any evidence of community transmission that we're not yet aware of our technical advisory group has a has a submarine epidemiology subgroup that met on Good Friday to look at the laboratory testing data by with the regional analysis and to provide us with advice around any regions where we might want to increase the testing for a period to just again look and make sure we are not missing cases out there so that will be happening over the coming week it will too so yes it's encouraging that we are seeing a smaller number of cases and that I think all New Zealanders should take out from that bit our collective efforts are are paying dividends final question yes well the high level of testing we're doing is informing is a thing effectively both diagnostic and some surveillance testing because Europe clearly with a positivity right now below two percent most of the tests are negative and we want to maintain that high level of testing I'll give you an example for Manila you might have seen as a DHB region has got had quite a low number of tests done and I had a text conversation with the chief exec there yesterday and said over this next week or so just to get be more liberal with the test and get anyone and who might symptoms of an influenza-like illness or respiratory illness and do some more testing just to make sure that that there are no no cases out there that we might be missing so that's an example yeah I think the case definition is already very bored broad and here would be just you know it might be instead of you know so it's encouraging people to go for testing so having a low threshold for a period of time and sending people for testing and it may be complemented with some testing as well and general practice where people come in with mild illness they could do the swabs or send them to the community based assessment centre for swabbing well at the moment we've seen quite good if distribution by ethnicity but we will look and see what the advice was from the subgroup I haven't seen that yet but in particular we're looking at regional differences and testing rates and also adjusting for EPS clusters that might be there it may be if you've got for example the the bluff cluster would increase the positivity rate in in the southern region because you know you were actually likely defined likely to find cases so you may want to do even though they've done quite a lot of testing down there you might want to do more testing to get the positivity rate down below at the moment it's 3% I think we should be looking at least over this week last week in this week for it to be down closer to 1% so well below the 2% level no the advice stands in terms of the appropriate use of it and I guess the the advices to make sure it is being used appropriately as part of the the range of infection prevention and control procedures have got in place so the advice for aged residential care which is on our our website is what was advised just generally in just re-emphasize in the key things about staff not coming to work if they're unwell anyone with a suspected or probable or confirmed and fiction should be immediately isolated clear messages around infection prevention control pressure process so that's the advice that's been updated just yesterday christchurch that are worried that the spread of Rosewood residents will have coveted here Bristow's what reassurance can you get around the work the moving Rosewood residents so I think you might have seen the pictures in the paper that all those residents when the DHB started working with the rest time all of those ones who are transferred to Burwood were transferred by hospital with very strict you know use of PPE and infection prevention and control so there'll be no risk to other facilities and some of the residents and another part of the Rosewood facility are still being cared for there with again good infection prevention control in place from the Rosewood facility yes but not from the part that had the infection as my understanding I can't say if they've been tested they would have been they wouldn't have been moved if there was any suggestion they had either been exposed or that if they were a possible or a suspected case look thank you very much again thanks for coming out on Easter Sunday and I look forward to continuing to work with you Kyoto Kyoto.
